PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Retrospective”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed2005

Uncovering the problem-solving process: cued retrospective reporting versus concurrent and retrospective reporting.

This study investigated the amounts of problem-solving process information ("action," "why," "how," and "metacognitive") elicited by means of concurrent, retrospective, and cued retrospective reporting. In a within-participants design, 26 participants completed electrical circuit troubleshooting tasks under different reporting conditions. The method of cued retrospective reporting used the original computer-based task and a superimposed record of the participant's eye fixations and mouse-keyboard operations as a cue for retrospection. Cued retrospective reporting (with the exception of why information) and concurrent reporting (with the exception of metacognitive information) resulted in a higher number of codes on the different types of information than did retrospective reporting.

Adolescent↗
PubMedDate not supplied

A checklist for retrospective database studies--report of the ISPOR Task Force on Retrospective Databases.

INTRODUCTION: Health-related retrospective databases, in particular claims databases, continue to be an important data source for outcomes research. However, retrospective databases pose a series of methodological challenges, some of which are unique to this data source. METHODS: In an effort to assist decision makers in evaluating the quality of published studies that use health-related retrospective databases, a checklist was developed that focuses on issues that are unique to database studies or are particularly problematic in database research. This checklist was developed primarily for the commonly used medical claims or encounter-based databases but could potentially be used to assess retrospective studies that employ other types of databases, such as disease registries and national survey data. RESULTS: Written in the form of 27 questions, the checklist can be used to guide decision makers as they consider the database, the study methodology, and the study conclusions. Checklist questions cover a wide range of issues, including relevance, reliability and validity, data linkages, eligibility determination, research design, treatment effects, sample selection, censoring, variable definitions, resource valuation, statistical analysis, generalizability, and data interpretation. CONCLUSIONS: For many of the questions, key references are provided as a resource for those who want to further examine a particular issue.

Data Interpretation, Statistical↗
PubMed1981

The case control or retrospective study in retrospect.

The epidemiologic case control design is described background information on its resurgence in popularity despite historical criticisms by its detractors. Weaknesses charged to the design by Feinstein and others such as its potential for recall bias in the use of retrospective data. Neyman's case selection bias, and the diagnostic suspicion bias are analyzed and shown to affect both the cohort incidence design and the clinical trial design as well as the case control.

Humans↗
PubMed2001

Is calculating pack-years retrospectively a valid method to estimate life-time tobacco smoking? A comparison between prospectively calculated pack-years and retrospectively calculated pack-years.

AIMS: To investigate the relative validity of retrospectively calculated pack-years (py-retro) by comparing py-retro with prospectively calculated pack-years (py-pro). DESIGN: A 23-year ongoing cohort study (1977-2000). PARTICIPANTS: One hundred and fifty-four males and females, 13 years old in 1977 and 36 years old in 2000. SETTING: Amsterdam, the Netherlands. MEASUREMENTS: To calculate py-pro, current smoking and quitting efforts were investigated nine times in a period of 23 years with the help of an interview or a questionnaire. At the age of 36, subjects filled out a comprehensive questionnaire about their smoking history, to calculate py-retro. Individual differences between py-pro and py-retro were calculated. In addition, Cohen's kappa was calculated after categorising py-pro and py-retro into three groups. FINDINGS: (1) Py-retro does not under- or overestimate life-time tobacco smoking. (2) The relative validity of py-retro was moderate due to large individual differences between py-pro and py-retro. (3) The individual differences between py-pro and py-retro became larger, the higher the number of pack-years. (4) Mean difference (and 95% limits of agreement) between py-pro and py-retro was -0.039 (-5.23, 5.32) when average pack-years was < 5.2 and -1.17 (-10.00, 14.65) when pack-years > or = 5.2. 5. Cohen's kappa between categorized py-pro and py-retro was 0.79. CONCLUSIONS: Future researchers in the field of smoking should be aware of the moderate relative validity of py-retro. Categorizing py-retro into smoking groups results in a misclassification error that is smaller than the quantitative error in continuous py-retro, but goes together with a loss of information.

Adolescent↗
PubMedDate not supplied

Results of surgical treatment of esophageal achalasia. Multicenter retrospective study of 1,856 cases. GEEMO (Groupe Européen Etude Maladies Oesophagéennes) Multicentric Retrospective Study.

A retrospective analysis of 1,856 patients treated by esophageal achalasia in 23 different surgical departments from seven countries is reported. The predominant symptom was dysphagia (100%), pain, vomiting and weight loss (76.1%). The most useful diagnostic methods were: barium meal (85%), manometry (100%), endoscopy (100%) and 99mTc (100%). Conservative treatment (5.45%) was useful in 5.8% only. Dilatation (16.9%) produced amelioration in 65.9%. Thoracotomy was used in 20.9% and middle line laparotomy in 79.2%. Heller esophagomyotomy was performed in 99.52% associated with anterior fundoplasty in 79.8% and postero-lateral (Mark IV) in 9.75%. Most of the patients were controlled through barium meal, esophagoscopy, esophageal manometry, pHmetry and 99mTc ingestion. Good results after Heller's myotomy with anterior fundoplication were 81.7% and poor 7.2%. Recurrence of achalasia was present in 184 patients. A new esophagomyotomy was performed on 58.6% and distal esophageal resection in 62 (35.3%). In total, 988 patients were reviewed once a year. Absence of gastroesophageal reflux was shown in 73.9% of the explored patients.

Adult↗
PubMedDate not supplied

[A retrospective study to an evaluation of the quality of Uniform Hospital Discharge Data Set regarding discharge with death of the patient attributed to a Diagnosis Related Group with a low Relative Weight; retrospective study in some hospitals in Rome [corrected]].

Aim of the present study is to evaluate the quality of medical record and Uniform Hospital Discharge Data Set (UHDDS), regarding admissions with death of the patient assigned to a Diagnosis Related Group (DRG) with a Relative Weight (RW) less than 1; the authors suggest that these admissions involve a more expensive hospital treatment if compared to admissions with favorable outcome and, therefore, the attribution of a DRG with RW more than 1 might be ascribed to an incorrect compilation of UHDDS. The admissions with the death of the patient, carried out between July 2002 and December 2002, in 11 different Rome hospitals located within the territory of two Local Health Units, have been split into 2 groups: admissions assigned to a DRG with RW less than 1 (group 1) and more than 1 (group 2). Afterward, two doctors of the Regional System of External Controls have required and examined the medical records of the group 1 (n= 57) using an evaluating format to verify the accuracy of UHDDS information. In the 91.0% (n=51) of the cases the UHDDS coding have been considered inadequate. In the 96.2% of the cases (n=49) the principal diagnosis has not been correctly coded while, in the 69.2% of the cases (n=36), at least one of the secondary diagnosis has been incorrectly reported. Medium RW rose from 0,7893 to 1,4354 after controllers' review and assignment of the new DRG. The results have confirmed the initial hypothesis and pointed out how an incorrect compilation of the UHDDS might compromise its validity under a statistic and epidemiologic point of view and produce significant repercussions under the economic one.

Adolescent↗
PubMed2002

Radiosurgery for residual or recurrent nonfunctioning pituitary adenoma.

OBJECT: Nonfunctioning pituitary adenomas comprise approximately 30% of all pituitary tumors. The purpose of this retrospective study is to evaluate the efficacy and role of gamma knife radiosurgery (GKS) in the management of residual or recurrent nonfunctioning pituitary adenomas. METHODS: A review was conducted of the data obtained in 42 patients who underwent adjuvant GKS at the University of Pittsburgh between 1987 and 2001. Prior treatments included transsphenoidal resection, craniotomy and resection, or conventional radiotherapy. Endocrinological, ophthalmological, and radiological responses were evaluated. The duration of follow-up review varied from 6 to 102 months (mean 31.2 months). Fifteen patients were observed for more than 40 months. The mean radiation dose to the tumor margin was 16 Gy. Conformal radiosurgery planning was used to restrict the dose to the optic nerve and chiasm. Tumor control after GKS was achieved in 100% of patients with microadenomas and 97% of patients with macroadenomas. Gamma knife radiosurgery was equally effective in controlling adenomas with cavernous sinus invasion and suprasellar extension. No patient developed a new endocrinological deficiency following GKS. One patient's tumor enlarged with an associated decline in visual function. Another patient experienced a deterioration of visual fields despite a decrease in tumor size. CONCLUSIONS: Gamma knife radiosurgery can achieve tumor control in virtually all residual or recurrent nonfunctioning pituitary adenomas. Dose sparing facilitates tumor management even when the adenoma is close to the optic apparatus or invades the cavernous sinus.

Adenoma↗
PubMed2005

Poor agreement between prospective and retrospective assessment of hallux surgery using the AOFAS Hallux Scale.

BACKGROUND: Retrospective assessment of preoperative status is common in nonprospective study designs. The aim of this study was to test the hypothesis that prospective and retrospective evaluations of the preoperative patient condition in hallux surgery gives equal results and therefore can be used interchangeably. METHODS: One hundred and fifty-nine consecutive feet with hallux surgery were analyzed prospectively. Parallel to routine evaluation of the preoperative status, the AOFAS Hallux Scale was recorded prospectively. Two years after surgery, the medical records were re-evaluated for retrospective reconstruction of the AOFAS score. Simultaneously all patients were asked to assess their preoperative status retrospectively. RESULTS: Using the medical charts for retrospective assessments, the preoperative status was estimated too low compared to prospective evaluation. This effect was even more pronounced with the patients' own retrospective assessment of their preoperative status. Linear regression coefficient for prospective and retrospective data showed moderate correlation with r = 0.59 for the AOFAS Score using the medical charts and poor correlation of r = 0.24 using the patients' own retrospective assessments. Spearman's rank correlation index was p = 0.57 and p = 0.23, respectively. The coefficient of repeatability according to Bland and Altman was 25.7 and 48.7 points, respectively, for the AOFAS score. The difference between the mean values of prospective and retrospective assessment was 5.6 (13.0) points. This means that a retrospectively evaluated AOFAS Score may be 31.3 points below or 20.1 points above prospective assessments (61.6 points below or 35.7 points above compared to the patients' own retrospective self-assessments). Agreement between individual items using Kappa statistics showed poor results except for metatarsophalangeal joint motion. CONCLUSIONS: Prospectively and retrospectively evaluated AOFAS scores cannot be used interchangeably for clinical outcome evaluations. Retrospective scoring gives worse results even when evaluated using conscientiously recorded medical charts and therefore leads to overestimation of the effect of surgery. These data support prospective study designs to ensure the best outcome analysis for clinical evaluation of hallux surgery.

Female↗
PubMed1997

Retrospective assessment of initial stroke severity with the Canadian Neurological Scale.

BACKGROUND AND PURPOSE: The severity of the initial neurological deficit is a critical determinant of outcome after acute stroke. Retrospective outcome studies are generally limited by a lack of quantitative data relating to this initial stroke severity. We evaluated the validity and reliability of measuring initial stroke severity retrospectively with the Canadian Neurological Scale (CNS). METHODS: The CNS was used to prospectively score the initial neurological deficit in a series of patients with acute ischemic stroke (n = 24). An algorithm was devised for applying the CNS retrospectively on the basis of information in the patient's hospital discharge summary. Those dictating the discharge summaries were not aware of the study, and the retrospective scoring was performed without reference to other scores. The level of agreement between the prospective and retrospective scores (validity) and both intraobserver and interobserver reliability for the retrospective scores were determined. RESULTS: Agreement was high between retrospective and prospective scores (r = .84, R2 = .71, P < .0001), between two sets of retrospective scores obtained by one rater (r = .95, R2 = .91, P < .0001), and between retrospective scores obtained by different raters (r = .91, R2 = .82, P < .0001). Weighted kappa statistics (kappa w) for prospectively versus retrospectively scored items varied from almost perfect (kappa w > 0.81 for level of consciousness and orientation) to substantial (kappa w = 0.68 for speech) and moderate (kappa w = 0.41 to 0.60 for facial weakness, proximal arm, distal arm, proximal leg, and distal leg strength). Using the retrospective algorithm, there was almost perfect intraobserver and interobserver reliability for each of the individual CNS items (kappa w = 0.81 to 1.00). CONCLUSIONS: These data show that retrospective scoring of initial stroke severity using an algorithm based on the CNS is valid and can be reliably performed using information available in hospital discharge summaries.

Aged↗
PubMed1994

Relationships between anthropometry and retrospective morbidity in poor men in Calcutta, India.

OBJECTIVE: The evaluation of body mass index (BMI) and other anthropometric measures as possible indicators of chronic energy deficiency, by examination of the relationships between these measures and retrospective morbidity in a group of very poor men in Calcutta, India. DESIGN: Anthropometric measurement and retrospective recording of treatment history over the previous year, from health records. SETTING: A primary care centre, the Middleton Row street clinic. SUBJECTS: All men attending the clinic for either provision of basic needs (food, clothing, plastic sheeting for building of shelter) or medical treatment during July and August, 1992. 190 men with 1-year retrospective treatment records were measured. INTERVENTIONS: None. RESULTS: Values for mean height, weight, arm circumference and triceps skinfold were lower than for any population of Indian males thus far reported. 44% of the men had BMI < 16, retrospective morbidity being two to three times higher in those below this cut-off than those above it. BMI < 16 was associated with greater retrospective morbidity due to respiratory tract infection and tuberculosis. For men aged 18-64 years, weight, height, arm circumference and age were significant discriminators of retrospective respiratory morbidity, while calf circumference, height, weight and age were significant discriminators of retrospective tuberculosis morbidity. Of the derived variables, BMI was a better discriminator of retrospective respiratory morbidity than arm fat area and percentage body fat, and the only discriminator of retrospective tuberculosis morbidity. For men aged > or = 65 years, weight and calf circumference were significant discriminators of respiratory infection, while age was the only discriminator of tuberculosis morbidity. Of the derived variables, BMI alone discriminated retrospective respiratory infection. CONCLUSION: BMI was the best overall discriminator of retrospective morbidity in this group of poor Calcutta men. Anthropometric criteria were better discriminators of retrospective morbidity in men between the ages of 18 and 64 years than in men aged 65 years and over.

Adolescent↗
PubMed2004

Validity of adult retrospective reports of adverse childhood experiences: review of the evidence.

BACKGROUND: Influential studies have cast doubt on the validity of retrospective reports by adults of their own adverse experiences in childhood. Accordingly, many researchers view retrospective reports with scepticism. METHOD: A computer-based search, supplemented by hand searches, was used to identify studies reported between 1980 and 2001 in which there was a quantified assessment of the validity of retrospective recall of sexual abuse, physical abuse, physical/emotional neglect or family discord, using samples of at least 40. Validity was assessed by means of comparisons with contemporaneous, prospectively obtained, court or clinic or research records; by agreement between retrospective reports of two siblings; and by the examination of possible bias with respect to differences between retrospective and prospective reports in their correlates and consequences. Medium- to long-term reliability of retrospective recall was determined from studies in which the test-retest period extended over at least 6 months. RESULTS: Retrospective reports in adulthood of major adverse experiences in childhood, even when these are of a kind that allow reasonable operationalisation, involve a substantial rate of false negatives, and substantial measurement error. On the other hand, although less easily quantified, false positive reports are probably rare. Several studies have shown some bias in retrospective reports. However, such bias is not sufficiently great to invalidate retrospective case-control studies of major adversities of an easily defined kind. Nevertheless, the findings suggest that little weight can be placed on the retrospective reports of details of early experiences or on reports of experiences that rely heavily onjudgement or interpretation. CONCLUSION: Retrospective studies have a worthwhile place in research, but further research is needed to examine possible biases in reporting.

Child↗
PubMed1993

Previous mammograms in patients with impalpable breast carcinoma: retrospective vs blinded interpretation. 1993 ARRS President's Award.

OBJECTIVE: We examined differences between blinded and retrospective reviews of screening mammograms obtained before a mammogram that resulted in the diagnosis of an impalpable breast carcinoma. MATERIALS AND METHODS: We reviewed 152 previous mammograms in 73 patients in whom impalpable breast carcinomas were subsequently detected on later mammograms. The earlier studies were interpreted in two ways: (1) blindly (without knowledge that carcinoma was subsequently detected) and (2) retrospectively (with the mammogram showing the carcinoma for comparison). The two interpretations were then compared with regard to the presence of carcinoma, recommendations for biopsy, parenchymal density, histologic characteristics of the tumor, lymph node status, and film quality. RESULTS: When we did a blinded review of the mammograms obtained before the diagnostic mammograms, the previous study was interpreted as showing evidence of carcinoma in 30 patients (41%). For the remaining 43 patients (59%), the findings of the most-recent previous mammogram were interpreted as normal or benign by the blinded reviewers; however, the retrospective reviewers thought evidence of cancer was visible in 25 of these patients (34%). Differences between blinded and retrospective interpretations were statistically significant. In patients in whom evidence of tumor was thought to be present on retrospective review but not on blinded review, the majority of mammographic abnormalities were asymmetric densities on the most-recent previous examination. This was true whether or not the retrospective reviewers thought that the mammographic finding warranted earlier biopsy. The histologic characteristics and lymph node status among patients in whom mammograms were interpreted retrospectively as showing evidence of tumor were no different from those among patients with no evidence of tumor. CONCLUSION: Our results show that impalpable breast carcinomas are frequently evident in retrospect on previous mammograms. However, because many are manifested only as an asymmetric density, these may not necessarily be true radiologic errors. Failure to detect a retrospectively visible abnormality on a screening mammogram is not necessarily negligent, and retrospective reviews do not reflect the everyday practice of screening mammography.

Awards and Prizes↗
PubMed1995

Retrospective versus concurrent review on the quality of care of pediatric trauma patients.

To compare and contrast retrospective versus concurrent quality of care review processes in a Level I Trauma Center, we conducted a retrospective chart review of all pediatric trauma admissions in 1990 (n = 113) and compared it to the concurrent trauma quality assurance program for the same time period. Twenty-four percent (24%) of the patients reviewed in the retrospective study were identified by filters and reviewed through the concurrent process. In both the retrospective and concurrent review process problems in medical care problems, documentation, social and preventive elements of the case, and overall assessment of the patients' care were described. Overall, we found less than 50% agreement between the two reviews. The retrospective review identified medical care issues in 64% of cases, compared with a 44% error rate noted in the concurrent review (P < 0.07). Reviewers were more likely to note the absence of appropriate documentation, and overall assessment of the patients' care in the retrospective process (P < 0.0001). The retrospective review also highlighted issues related to the prevention of the injury and the patients' social situation, which were not considered by the concurrent review. Overall, we found the concurrent review appropriate for case by case medical management, while the retrospective review was relevant to a systems approach to the care of the injured child. To obtain a complete picture of the care of injured children, we recommend 1) a portion of charts be reviewed retrospectively in addition to ongoing concurrent review; or 2) the concurrent review add filters that are specific to pediatric issues and overall system issues.

Adolescent↗
PubMed2000

Retrospective assessment of initial stroke severity with the NIH Stroke Scale.

BACKGROUND AND PURPOSE: It is important to adjust stroke outcomes for differences in initial stroke severity. The NIH Stroke Scale (NIHSS) is a commonly used stroke severity measure but has been validated for retrospective scoring only in a subset of stroke clinical trial participants. The purpose of this research was to assess the validity and reliability of an algorithm for retrospective NIHSS scoring in a setting with usual chart documentation. METHODS: An algorithm for retrospective NIHSS scoring was developed with written history and physical admission notes. Missing physical examination data were scored as normal. One investigator prospectively scored the admission NIHSS in 32 consecutive stroke patients. Two raters retrospectively scored the NIHSS by applying the algorithm to photocopied admission notes. Linear regression was used to assess interrater reliability and agreement between prospective and retrospective NIHSS scores. The Wilcoxon signed rank test was used to assess systematic scoring bias. Weighted kappa statistics were calculated to assess the level of agreement of individual NIHSS items. RESULTS: Only 1 admission note was complete for all NIHSS elements. Interrater reliability was near perfect (r(2)=0.98, P<0. 001). Agreement between prospective and retrospective NIHSS score was also excellent (r(2)=0.94, P<0.001) and there was no systematic bias in retrospective scores. Agreement for individual items was moderate to high for all items except level of consciousness. CONCLUSIONS: Retrospective NIHSS scoring with the algorithm is reliable and unbiased even when physical examination elements are missing from the written record. Stroke research using retrospective review of charts or of administrative databases should adjust for differences in stroke severity using such an algorithm.

Aged↗
PubMed2000

[Corroboration of concurrent assessment of inappropriate hospitalization with retrospective evaluation based on patient records].

BACKGROUND AND PURPOSE: Since the availability of a German adaptation of the "appropriateness Evaluation Protocol" (AEP) for hospital utilization review, physicians and health care managers were concerned about a potential overestimation of the extent of inappropriate hospital use in a retrospective assessment. The objective was to assess the agreement of concurrent and retrospective assessment of inappropriate hospital use. METHODS: The appropriateness of 42 admissions to surgical wards in a teaching hospital was tested concurrent to the admission. In 25 hospitalized patients the appropriateness of hospital days was assessed. Results were compared with the retrospective testing of the same patients after three months. RESULTS: Agreement between concurrent and retrospective assessment within the same reviewer was 86% of admissions (95% CI = 75%-96%) and 96% of hospital days (88%-100%). Kappa showed values of 0.85 and 0.78, which can be described as excellent. A comparison of two different reviewers, one testing concurrently, the other retrospectively showed agreements of 86% and 90%. The proportion of inappropriate days was the same in both designs. CONCLUSIONS: The results refute prior concerns that a retrospective assessment of the appropriateness of hospital use is impossible because in a retrospective design important clinical information would remain unconsidered or clinical information not yet available at that time would be used for the evaluation. The possibility of an incorrect assessment due to a retrospective design is within the variability inherent to the instrument. Despite the strong agreement, the small sample of surgical patient limits the generalizability of results.

Concurrent Review↗
PubMed2005

Reliability of retrospective clinical data to evaluate the effectiveness of lumbar fusion in chronic low back pain.

STUDY DESIGN: Patients in whom a posterior spinal fusion instrumentation had been performed to treat low back pain were asked to recall their preoperative clinical status by retrospectively filling out the same 3 self-evaluation scales they had completed before surgery in a prospective fashion. OBJECTIVES: To evaluate the impact of recollection error and compare outcomes using retrospective versus prospective methodologies among a cohort of patients treated with posterior spinal fusion instrumentation. SUMMARY OF BACKGROUND DATA: Literature on spine surgery from 1990 to 2000 shows a greater increase in retrospective studies as compared to randomized controlled trials and other prospective studies. Cross-sectional studies evaluate therapeutic effectiveness by comparing the current condition with the recalled (retrospectively recorded) pretreatment condition. There are no studies analyzing the characteristics of recalled data in a cohort of patients with chronic low back pain treated with posterior spinal fusion instrumentation. METHODS: The preoperative clinical status of 58 patients, 33 women and 25 men, with a mean age of 48.3 years (22-84 years) was assessed prospectively with 3 self evaluation questionnaires and retrospectively at a mean of 37.5 months (2-58 months) after surgery using the same questionnaires. The Wilcoxon test was used to compare prospective and retrospective preoperative data and to compare prospective outcomes with outcomes determined from cross-sectional data. Agreement between prospective and retrospective measures was estimated with intraclass correlation coefficients for absolute agreement and consistency. RESULTS: Comparisons between prospective and recalled data showed significant differences, demonstrating a worse preoperative situation when using retrospective data. Assessment of treatment effectiveness showed that cross-sectional evaluation significantly improved the real surgical outcome. Both absolute agreement and consistency intraclass correlation coefficients showed poor agreement between prospective and cross-sectional data, revealing no systematic bias. Follow-up, age, and gender did not modify agreement and cross-sectional overestimation. CONCLUSIONS: Relying on a patient's recall of preoperative clinical status is not an accurate method to evaluate surgical outcome after posterior spinal fusion instrumentation. Cross-sectional studies may overestimate the effectiveness of surgery.

Adult↗
PubMed1991

Evaluation of the sexual consequences of surgery: retrospective and prospective strategies.

To assess the impact of a stressor, it is desirable to evaluate affected individuals' status both prior to and following a stressful event. Because of the difficulties inherent in prospective designs, investigators often ask people who have experienced an aversive event to evaluate their prestressor adjustment retrospectively. Do such retrospective evaluations provide a reasonable alternative to prospective assessment? To answer this question we compared retrospective and prospective data gathering procedures in the evaluation of sexual adjustment after prostate surgery. One hundred fifty-two married males who had undergone prostatectomy for benign prostatic enlargement completed a battery of measures which evaluated pre- and postsurgical sexual adjustment either prospectively (i.e., before and after surgery) or retrospectively (i.e., ratings made after surgery of both pre- and postsurgical adjustment). Retrospective assessment indicated considerable sexual deterioration pre- to postsurgery. In subjects tested prospectively, however, the results showed that surgery had little impact on sexual adjustment. Moreover, direct comparisons of retrospective and prospective methodologies reveal that discrepancies are due to differences in evaluations of presurgery status, with retrospective evaluation yielding more favorable ratings than prospective assessment. The results highlight a variety of biases which may affect self-ratings of pre- and post-stressor adaptation and show that discrepancies associated with the two methodologies have important implications for understanding the impact of a stressor on adjustment.

Aged↗